抑郁情绪对慢性鼻窦炎内镜术后患者症状改善的影响

Influence of depression on symptom improvement in chronic sinusitis patients after endoscopic surgery

目的探讨抑郁情绪对慢性鼻窦炎(CRS)内镜术后患者症状改善的影响。方法选择本院2018年1月~2020年6月120例CRS内镜术后患者作为研究对象,根据术后汉密尔顿抑郁量表(The Hamilton Depression Scale,HAMD)分数,设为抑郁组(45例)与非抑郁组(75例),采用视觉模拟评分(Visual analog scale,VAS)评估鼻塞、头昏/头痛、嗅觉障碍、鼻分泌物、面部疼痛、鼻后滴漏等CRS主观症状,以及Lund-Mackay内镜评分评估黏膜炎症状态、黏液性分泌物、脓性分泌物等客观症状,分析HAMD评分与主观症状、客观症状评分的关系。结果抑郁组鼻塞、头昏/头痛、嗅觉障碍、鼻分泌物、面部疼痛、鼻后滴漏等CRS主观症状VAS评分均显著高于非抑郁组(P<0.05);抑郁组黏膜炎症状态、黏液性分泌物、脓性分泌物等Lund-Mackay内镜评分均显著高于非抑郁组(P<0.05);HAMD评分与主观症状、客观症状评分均呈显著正相关关系(P<0.05)。结论抑郁情绪会影响CRS内镜术后症状改善,临床宜根据患者实际情况进行针对性心理干预,以促进术后症状改善。

Objective To study the influence of depression on the symptom improvement of chronic sinusitis(CRS) patients after endoscopic surgery. Methods A total of 120 CRS patients after endoscopic surgery in our hospital from January 2018 to June 2020 were selected as the study subjects. The Hamilton Depression Scale(HAMD)were investigated.They were set as the depression group(45 cases)and the non-depression group(75 cases). Visual analog scale(VAS)was used to evaluate subjective symptoms of CRS such as nasal congestion,dizziness/headache,olfactory disturbance,nasal discharge,facial pain,and postnasal drip. The Lund-Mackay endoscopic score were used to evaluate objective symptoms such as mucosal inflammation,mucous secretions,and purulent secretions. The correlation between HAMD score and subjective symptom and objective symptom score were analyzed. Results The VAS scores of subjective CRS symptoms such as nasal congestion,dizziness/headache,olfactory disturbance,nasal discharge,facial pain,and postnasal drip in the depression group were significantly higher than those in the non-depression group(P<0.05). The LundMackay endoscopic scores of mucosal inflammation,mucous secretions,and purulent secretions in the depression group were significantly higher than those in the non-depression group(P<0.05). HAMD score was significantly positively correlated with subjective symptoms and objective symptom scores(P<0.05). Conclusion Depression will influence the effect of CRS endoscopic postoperative symptom improvement. Clinically,targeted psychological intervention should be carried out according to the actual situation of the patient to promote postoperative symptom improvement.